The US Presidency and the stigma of mental health
In the UK, today is ‘Time to Talk Day’ — a day set aside by the ‘Time to Change’ campaign to encourage people to talk about their own mental health issues and to listen to others perspectives and experiences. The intention is straightforward: by talking about mental health, by being open about our own struggles and understanding the struggles of others, we begin to break down the stigma that having a mental health condition carries. It is a great thing to do.
I’ve been open about my own mental health issues for quite a few years now. I have anxiety issues and OCD, and have had (and will almost certainly have again) therapy, and taken medication. I don’t feel like I have faced much direct discrimination because of my condition, in part because I have been so open about it, which has meant I have been able to control the flow of information. At work, for example, I helped to set up an employee wellbeing group, and have given talks on my own experiences. When I stand in front a room full of people, giving a presentation or a talk, I know that I don’t seem (for want of a better word) ‘mental’. People are not getting to know me through my mental illness, they know me for me, as the confident person talking openly and rationally to them, and so that is how they judge me.
But I get that the situation is different when people know about the condition before they know the person. In truth, I don’t know what conversations have happened behind closed doors, what pieces of work have not come my way because people might be worried about my mental health, what judgements have been made about my performance or capacity based on incomplete knowledge or prejudice.
I have been thinking about this a lot lately in the context of the Trump Presidency, because I have seen an increasing number of articles, memes, and comments reflecting on his mental health. Typical would be a suggestion that he has some form of narcissistic personality disorder, with an implicit or explicit implication that this means he is unfit to be President (for example).
This kind of pseudo-psychological assessment feels problematic for two reasons.
First, it removes the right of the man to be judged on his actions and his beliefs, instead using his mental health — diagnosed from afar with limited evidence — as the driver for his decisions. Quite apart from the dangerousness of making a diagnosis based on extremely limited information (see this excellent article from 538 on the history of diagnoses from distance in US Presidential races), this approach does him a diservice whether you agree with his policies and decisions or not.
We can look at it another way by considering the fact that 1 in 4 people are suffering from some form of diagnosable mental health condition at any one time. 1 in 4. Now, my experience of the world at large is that more than 1 in 4 people make bad calls. There are plenty of people in the world who are stupid, mean spirited, and plain wrong. I want these people to be judged for how they act and what they do. I don’t want them to be let off the hook because they may have a mental health issue at any given time. Because a shed load of them will be struggling and suffering, but that isn’t an excuse. If you disagree with Trump, do it based on what he does and what he says. You don’t need to find another reason.
Second, it perpetuates the stigma around mental health. These articles, memes, etc. too often call into question his ability to govern because he has (supposedly) some form of mental health issue. How is this not straightforward discrimination? How is it better than saying that somebody can’t be president because they have asthma? Or are a woman? Or are black? Having a mental health condition does not prevent you being a success. It may mean you need help, treatment, support. But it doesn’t of itself mean you are unfit to govern. And, to be clear, if 1 in 4 people are suffering from some form of mental health condition at any one time, it is almost inconceivable that many previous incumbents of the Oval Office have not been amongst their number whilst in office. Indeed, we know that one of the most celebrated of British Prime Ministers — Churchill — suffered from almost crippling depression much of the time.
How about looking at it through the lens of a fictional President — Josiah Bartlett of West Wing fame. In Series 3, Bartlett spends some time with a counsellor — Dr Stanley Keyworth — initially to talk about some sleeping problems, but the conversation quickly turns to deeper pschological issues. This is all done in secret, with Dr Keyworth snuck in, meeting the President in secret to avoid anybody finding out that the President is seeing a mental health professional. What makes this even more pertinent is the timing. In the arc of the story, this is a point when Barlett is running for reelection, following the sensational public disclosure of the impact of his physical health problems in the shape of MS. That disclosure was challenging for him during his reelection — not because of the MS per se, but because he had a serious health condition and didn’t reveal it to the American people whilst running for office. Yet, at the exact same time, he is going to extraordinary lengths to repeat the same process about some mental health issues. As though the American people could be expected to come to terms with a serious physical health condition, but could not accept that he might want a bit of help dealing with the mental pressures of the job, and working through some difficult issues from his childhood. Perhaps the most telling thing is that it doesn’t feel far-fetched at all.
I guess, for me, the bottom line is that it doesn’t matter whether Trump — or anybody else — has a mental health condition. There are people who are kind, loving, well-intentioned, intelligent, and who make a massive and positive difference to the world. A lot of them have mental health problems. There are people who are small-minded, bigoted, hateful, stupid, and mean. A lot of them have the same mental health problems. Having a mental illness doesn’t define anybody — any more than having MS, for example, would mean you are a good or bad person.
So, if you have a problem with Trump (or any other politician for that matter, of whatever political persuasion), don’t fall into the lazy prejudice of saying it is because he is ‘mental’. Face the fact that sane people are capable of doing things and behaving in ways you passionately disagree with. That might just be the scariest fact of all.
